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Prescription Drug Marketing Argument

      The pharmaceutical industry in the United States has emerged as one of the most lucrative and influential industries in recent history.  Since 1997 we have witnessed the birth of direct-to-consumer (DTC) marketing of prescription drugs through nearly every media stream available.  Depression, anxiety, diabetes, and arthritis are among the most highly advertised conditions.  Corporate giants in the industry compete for a greater market share for medicating each illness; relentlessly driving delusive information down the consumer’s throat in a thirty second T.V. spot. The mass marketing of prescription drugs has created an unethical and excessively competitive environment within the pharmaceutical industry and has negatively impacted American consumers and their families. Additionally, the physician has become an important marketing target of the pharmaceutical industry.  For-profit drug manufacturers have taken the responsibility of educating our doctors about new medicines available to treat their patients.  There are limited regulations on the information presented to doctors during sales presentations (Santi 1). It is safe to assume that the sales representative will likely be providing information that is beneficial to his sponsoring company, and not to mention his commission.  Government regulation must be prescribed to cure our deteriorating medicine practice.

      The federal government has imposed pharmaceutical marketing laws in the past, but there has been little litigation to fix current problems.  On April 22, 1988 President Reagan signed the Prescription Drug Marketing Act (PDMA) to prevent the sale of counterfeit and sub-quality medications.  The original provisions required advertisers to go into comprehensive detail of the side effects and contradictions of the medication when directed towards the consumer (Congress 1). This standard made television, radio, and print advertisements impracticable as effective means of advertisement.  After a series of appeals hearings in 1997, the PDMA was amended.  The revised version, which is still in use today, relaxed the original guidelines and permitted DTC drug advertisements with only a brief mention of side effects and contradictions. 

      After the PDMA was revised, the United States saw an immediate influx of DTC advertisements.  The consumer was presented with an array of miracle medications for common illnesses that include migraines, restlessness, and impotence, among many others.  Alluring T.V. commercials encourage viewers to seek the help of a medical professional if they suffer from any of the many symptoms listed. By intensifying the seriousness of common inconveniences, advertisers are able rally the public to seek treatment from their doctors. More patients results in more prescriptions, which results in more profits for the drug manufacturer. A common drug advertisement may read as follows, “Are you getting less than 8 hours of sleep every night?  Do you feel the need to rest in the middle of the day?  If you answered yes, you should see your doctor and ask about our medication.” Pharmaceutical marketers have recognized value of increasing the urgency and seriousness of common ailments and have been able to profit greatly using this tactic.

      Successful marketing bans in other countries serve as examples of better systems that exist in the world today. Nearly every country in the Western Hemisphere has banned DTC marketing of prescription drugs, with the exception of the United States and New Zealand. For the sake of simplicity, I will focus on the prescription marketing policy of Canada.  In 1978, the Canadian government passed the Food and Drugs Act (Mintzes 7). Pharmaceutical companies are prohibited from mentioning brand name, common name, proper name and price of any prescription medications in advertisements.  By enforcing these regulations, Canadian corporations have avoided the multi-million dollar lawsuits that are common in the United States.  Also, patients have been found to be far less partial to particular drugs.  A double blind study was done recently to examine the effect of DTC marketing between American and Canadian patients.  1,431 patients from the cities of Sacramento, CA and Vancouver, BC were asked to fill out questionnaires regarding pharmaceutical advertisements.  The patients from Sacramento were found to be 17 times more likely to request a specific medication by brand names (Mintzes 11).  The brand name, of course, was obtained from main stream marketing practices.  More troubling is fact that two thirds of the patients requesting the specific drug actually received the prescription. This study shows the strength of mass marketing on both the patient and the physician.  Canada has used findings similar to this to keep a fair and balanced medicine practice alive in their country.

      Major controversies within the pharmaceutical industry have been commonplace throughout the last 10 years.  The most recent of which surfaced with Merck & Co., regarding the arthritis pain reliever Vioxx.  Approved by the FDA in 1999, Vioxx had become one of the most prescribed drugs in American history within a few short years.  An estimated 80 million patients received prescriptions for the drug (Topol 1707). The success is largely due in part to one of the most aggressive advertising campaigns for a prescription drug in history.  Vioxx was voluntarily taken off the market in 2004 by Merck & Co. because it was discovered that it greatly increases the risk of heart attack of its users.  There were several clinical studies conducted prior the drug’s release that illustrated the complications of the drug.  However, Merck & Co. had a great opportunity at the time to profit massively from the drugs release, and pushed for the Approval of Vioxx (Topol 1707). 

      After the approval, Merck & Co. wasted no time before running the initial ad campaigns.  Rival drug manufacturer Pfizer was dominating the market with pain reliever Bextra and dynamic DTC marketing is the key to lucrative prescriptions. Vioxx truly appeared as a miracle drug for arthritis suffers.  Television commercials promised “Powerful pain relief, without the upsetting effects of other medications,” which is a true, but misleading description of the medication.  There is only an extremely quick mention of possible side effects at the end of the commercial.  Keep in mind that this is all in compliance with United States law, and Merck & Co. has not advertised illegally.  However, important clinical studies have been overlooked and suppressed by Merck & Co. that compromise the safety of Vioxx users.  The failure to ensure safety to patients and negligence of medical ethics has caught up with the manufacturer.  There have been over 40,000 lawsuits filed against the company since its withdrawal in 2004 and an amazing one million dollars per day is spent on legal fees alone (Topol 1707).

      Vioxx users are not the only victims of Merck & Co.’s negligence.  American investors have lost millions as the company’s stock price plummeted almost instantaneously.  Also, 7,000 employees were laid off after the law suites started pouring in.  I do not blame Merck & Co., or its directing officers, for the development of the Vioxx controversy.  The drug required intense marketing to be successful, and Merck & Co. took full advantage of the current marketing laws in the United States.  Had laws been in place to limit the amount advertisements of the drug, we would have been able to recognize the dangers before 80 million patients had been affected.  Furthermore, the manufacturer would not have been as aggressive in seeking approval from the FDA.  Government restrictions must be imposed on the current pharmaceutical marketing system to prevent future catastrophes of a similar nature.

      Although direct-to-consumer marketing is the most visible form of pharmaceutical marketing to the average consumer, major drug corporations invest a greater amount of effort in marketing to doctors.  Nearly all pharmaceutical companies in the United States employ a massive force of sales professionals to market to health care providers.  Sales professionals in the prescription drug industry are referred to as detailmen. They are there for the purpose of educating doctors on their company’s products.  Detailmen build strong relationships with clients and encourage that their drug be prescribed over their competitors.  It is a highly competitive environment and detailmen are under constant pressure by their sponsoring companies to increase their sales. It is common for detailmen to offer incentives to physicians.  The following quote is an observer’s depiction of a typical sales tactic, “After a half an hour or so of light, boozy sales patter, the cook produces the order, the detailman produces his wallet, and the doctor walks away with dinner for the whole family” (Santi 1). Not only are licensed physicians being solicited, but medical students are being targeted as well.  Drug companies spent an estimated 5 billion dollars in 2005 to persuade doctors through the use of detailmen (Mintzes 20). This amount is likely to increase in the coming years and is directly affecting patients who seek prescription drugs. 

      A principled medicine practice should keep the choice of prescriptions wholly with the medical professional.  When a doctor is persuaded with extravagant gifts, his choice is not based one hundred percent on the patient.  He must take into account the patients medical condition as well as the detailman’s opinions.  It is in the best interest of the patient to have an unbiased judgment from his doctor.  Most doctors will assert that the sales tactics of detailmen have no effect on their decisions.  However, research from pharmaceutical companies show that this type of marketing is highly successful. Although exact numbers are virtually impossible to determine, research shows that a greater sales force results in a higher amount of prescriptions from the targeted doctor (Weber 54). In fact, a greater amount of investment is used towards marketing to physicians than is used for DTC marketing.  Logically, there is an obvious benefit to eliminating persuasive marketing to physicians.  The physician will be able to spend more time evaluating a patient and less time being pedaled one-sided information that may be harmful to the prescription drug user. 

      Proponents of prescription drug marketing have numerous interesting and valid points to make about the benefit of mass marketing.  Many people believe that direct-to-consumer advertisements are beneficial to the patient.  Marketing can make a person aware of a serious medical condition that may be going untreated.  Common illnesses that often go untreated include depression, social anxiety, high blood pressure, and sleeplessness (Weber 13).  Informative television commercials can stimulate a person’s desire to seek advice from their doctor about their condition.  Without this information being available in the popular media, many people will lack important information about their own health.   Furthermore, if the patient decides to speak with a medical professional they will be more prepared and knowledgeable when the consultation takes place.  Some proponents have stated that it is important for a patient to have a strong sense of autonomy.  People should retain independence and have their own opinion when discussing medical issues.  The existing consensus among Americans is that prescription drug advertisements are beneficial to the public (Norman 1).  They serve as a mechanism of education that can keep a massive amount of people informed of new medical treatments available.  DTC marketing is able to reach great amounts of people in America and the general opinion is supportive of the current pharmaceutical marketing system.

      Pharmaceutical corporations have many positive aspects about detailmen and their betterment of the medical community.  Just as DTC marketing informs patients, detailmen educate healthcare professionals. Without detailmen, doctors would be forced to do all their medical research independently.  New and effective medications may go unnoticed by a busy doctor.  A competitive sales environment ensures that a doctor will be enlightened on all possible medications for common illnesses. Also, doctors have continually reported that marketing from drug manufacturers has little to no effect on their actual decision on which medication to prescribe.  The most power benefit of both DTC and physician marketing is the power to educate.  Without mass marketing, the American public would be ignorant about many of the cutting edge treatments available illnesses today.

      Education is a very important for both patients and physicians, however, receiving this education through the mass media may be counterproductive.  The true intention of pharmaceutical advertisements must be evaluated before a reasonable conclusion can be made.  Public for-profit corporations and their directing officers are looking out for their bottom line, and what is in the interest of the share holders.  In most cases, what is good for the share holder is good for the customer. But this is not always accurate in the pharmaceutical industry.  For example, we saw how Merck & Co. abused its marketing power and the result for devastating for the consumers.  This is not an isolated case.  Pfizer and Glaxo-Smith-Kline have also had to recall medications after millions of dollars had been spent “educating” doctor and patients.  These misjudgments are examples of our failing system and will continue to occur until stricter regulation is enforced. 

      It is necessary for information to be completely unbiased when we educate any individual on medical conditions.  Our current marketing regulations allow corporations to provide consumers and professionals with information partial to their product.  This may stimulate more activity within the medical community, but it may be harmful if the information is misleading.  Drug manufactures should have their finding analyzed by third party sources to assure consumers that the information is accurate.  Although the American public, both consumers and professionals, support our current prescription drug marketing system, it does not necessarily mean it is a good system.  In the 1930’s the majority of Germany supported the rise of the Nazi party, which proved to be a dire mistake.  History has proven that a majority consensus is not necessarily correlated with what is beneficial for society.

      There is an ample amount of evidence to support the conclusion that the mass marketing of prescription of drug is detrimental to American society.  Marketing has become excessively competitive among the major pharmaceutical corporations.  This dog-eat-dog environment has caused an abundance of false and misleading information to be provided to consumers, and most importantly our doctors.  The marketing restrictions in other countries, such as Canada, have allowed manufacturers to focus on research and development.  Pharmaceutical laws from nations throughout the world serve as an example of how we can improve America’s flawed system.  Since 1997 we have already seen numerous cases in which pharmaceutical manufactures have abused their privilege to advertise through popular media streams.  Until stricter regulations are enforced by the federal government, it is wise to approach with caution when considering a medication that is advertised through the mass media.

 


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